A phase I trial of recombinant leukocyte alpha 2 interferon in patients with advanced malignancy

Phase 2 trial of the continuous IV administration of interferon-beta in patients with disseminated malignant melanoma

BACKGROUND

Interferons have been reported to significantly contribute to tumor suppression via both induction of p53 gene expression and inhibition of angiogenesis.

OBJECTIVE

The assessment of treatment toxicity and antitumoral effectiveness of continuous IV administration of interferon-beta based on an overall evaluation of laboratory, radiographic, and clinical parameters observed during the trial.

METHODS

The authors treated patients with advanced malignant melanoma with continuous IV infusions of 1 x 10(6) IU interferon-beta daily ( approximately 0.6 x 10(6) IU interferon-beta/m2 daily).

RESULTS

Continuous IV administration of interferon-beta had no significant effect on overall patient outcome. Interferon side effects were not a reason for treatment discontinuation in any of the patients observed during this trial.

CONCLUSIONS

Continuous IV interferon-beta had no significant effect on overall patient outcome in a group of patients with advanced malignant melanoma. To our knowledge, this is the first report on the continuous IV administration of interferon-beta in patients with advanced malignant melanoma.

Neurotoxicity of intraventricularly administered alpha-interferon for leptomeningeal disease

Nine patients with leptomeningeal disease are reported who were treated with intraventricular alpha-interferon (alpha-IFN). In seven of these patients, a progressive vegetative state developed during treatment. The patients became unresponsive to verbal commands but opened their eyes with auditory or tactile stimulation. It took an average of 3 weeks for these patients to become verbally responsive after treatment was discontinued. Electroencephalographic findings showed evidence of irritative involvement of the deep midline nuclei in 80% of patients. Periventricular white matter changes developed during treatment in three of six patients who underwent computed tomographic scans. All patients with this severe neurotoxicity received whole-brain irradiation before treatment. Possible mechanisms for the development of this neurotoxic syndrome are discussed. The neurotoxicity of alpha-IFN and brain irradiation may be additive, suggesting a cautious approach when using this combination for treatment.

Cardiotoxicity of interferon. A review of 44 cases

Cardiovascular complications have occurred in clinical trials of interferon. We review herein experience to date of cardiotoxicity with all types of interferons in cancer patients. The most common presentations of cardiotoxicity were cardiac arrhythmia, dilated cardiomyopathy, and symptoms of ischemic heart disease, including myocardial infarction and sudden death. The cardiac effects were not related to the daily dose, cumulative total dose, or period of therapy. Some of the patients in whom interferon has caused cardiovascular sequelae have had a history of coronary heart disease or have previously been given chemotherapy with drugs known to be cardiotoxic. In most of the patients, cardiac toxicity was reversible following the cessation of the drug therapy.

Inhibition of proliferation of lines derived from human cervical carcinomas by cytotoxic drugs and by recombinant interferons

The authors studied the effects of recombinant interferons (IFN), doxorubicin, and cisplatin against three cell lines derived from human epidermoid cervical carcinomas. These lines were SW 756, containing the genome of human papillomavirus (HPV) type 18, and CaSki and SiHa, containing HPV type 16. IFN-gamma suppressed the growth of all three lines, with a plateau in inhibitory effect beyond a concentration of 1000 units/ml. IFN-alpha was effective in this regard only against SW 756. In this line, the two IFNs together inhibited cell replication to a greater extent than the maximal effect of either IFN alone. Doxorubicin exerted a dose-dependent cytotoxic effect against all the lines, while cisplatin exhibited cytotoxicity only against SW 756. Doxorubicin and IFN-gamma, when used together, acted synergistically against CaSki and SiHa, and in an additive manner against SW 756.